Without alcohol, before and after: from 7 days to 1 year

What changes when you stop drinking alcohol – after 7 days, after a month, after 1 year without alcohol? There are plenty of ‘before and after’ stories online. This timeline is based on what guidelines, specialist organisations and studies show. First, two points: the extent of the changes depends heavily on how much you used to drink. And anyone who is alcohol-dependent should not try to stop on their own, as stopping suddenly can trigger severe withdrawal symptoms.

How much alcohol is consumed in Germany?

According to the German Centre for Addiction Issues (DHS), Germany has been consuming very large amounts of alcohol by international standards for many years. In 2024, consumption stood at 10.0 litres of pure alcohol per capita among those aged 15 and over; in 2012, the figure was 11.7 litres. According to the 2024 Epidemiological Addiction Survey, 8.6 million people aged between 18 and 64 had consumed risky amounts of alcohol in the previous 30 days – that is, on average more than 12 g of pure alcohol per day for women and more than 24 g for men. 3.9 million adults in this age group had an alcohol-related disorder, 2.2 million of whom were dependent.

According to the German Nutrition Society, there is no amount of alcohol that can be consumed without risk. Alcohol increases the risk of at least seven types of cancer and many other diseases.

An overview of the timeline

After a few hours: the body breaks down the alcohol

About 30 minutes after drinking, alcohol reaches the liver and the breakdown process begins. This first produces acetaldehyde – a highly toxic, carcinogenic intermediate product that is also responsible for hangovers. On average, women break down 0.1 per mille per hour, whilst men break down 0.1 to 0.2 per mille; coffee or cold showers do not speed up this process. At 1.0 per mille, it takes around ten hours for all the alcohol to be cleared from the blood.

Even the very first night can turn out differently. A review of sleep studies involving volunteers shows that alcohol helps you fall asleep more quickly, but disrupts the second half of the night. In most studies, moderate and high levels of alcohol also reduce the proportion of REM sleep over the course of the night.

After 1 to 3 days: Withdrawal is a warning sign

According to the German S3 guideline, alcohol withdrawal syndrome occurs when alcohol has been consumed repeatedly, usually over a prolonged period and in high doses, and is then stopped or drastically reduced. It usually begins six to eight hours after the last drink. Typical symptoms include, amongst others, tremors, sweating, nausea, vomiting, anxiety, palpitations and high blood pressure. The symptoms usually peak after 10 to 30 hours and generally subside after 40 to 50 hours.

Severe cases are dangerous. It is thought that fewer than 5 per cent of those affected experience seizures or withdrawal delirium; withdrawal seizures typically occur within the first 12 to 48 hours. Delirium can still occur up to three to five days after the last drink and must be closely monitored, often in an intensive care unit.

If you notice a racing heart, tremors or sweating, speak to your doctor – these could be signs of addiction. People with an alcohol addiction need medical support when giving up drinking.

After 7 days: What a week without alcohol brings

In the case of dependence, withdrawal is temporary: the full severity is reached within 48 hours, and most physical symptoms subside after a further four to five days. Psychological symptoms often take weeks to subside.

Blood pressure is also affected. A meta-analysis of 36 studies involving 2,865 participants assessed reductions in alcohol consumption lasting at least seven days. Those who had previously drunk more than two drinks a day had lower blood pressure afterwards. The effect was most pronounced for those consuming six or more drinks a day, whose intake was roughly halved: on average, a reduction of 5.5 mmHg in the systolic reading and around 4 mmHg in the diastolic reading. No significant reduction was observed for those consuming up to two drinks a day.

After 14 days: blood tests and liver function

To detect chronic alcohol consumption, doctors use, amongst other things, the blood markers GGT, MCV and CDT. CDT has a half-life of 14 days and returns to normal levels once alcohol consumption ceases; the γ-CDT value, calculated from GGT and CDT, returns to normal within two to three weeks. GGT takes between three weeks and 60 days to return to normal levels following complete abstinence.

The liver gets a chance too. Anyone who drinks too much over the long term risks developing a fatty liver, and you won’t notice it because a diseased liver doesn’t cause any pain. If alcohol consumption is significantly reduced or stopped altogether, fatty liver can resolve – even a break of several weeks is sufficient for this, according to ‘Know Your Limit’. In the case of alcohol-related fatty liver, however, complete abstinence is necessary, according to the German Liver Foundation.

After 30 days: What a month without alcohol reveals

A study carried out in London investigated this. 94 people who drank moderately to heavily – an average of around 258 g of alcohol per week – abstained for one month; a control group of 47 people continued to drink. Anyone with liver disease or an alcohol dependency was not allowed to take part. After the month, the abstinence group had seen a reduction of around 26 per cent in insulin resistance, 6.6 per cent in systolic blood pressure, 6.3 per cent in diastolic blood pressure and 1.5 per cent in body weight. Levels of two growth factors associated with cancer were also lower. No significant changes were observed in the control group.

Self-reported data paint a similar picture. In a survey conducted by the University of Sussex amongst participants in Dry January 2018, 71 per cent said they slept better, 67 per cent had more energy, 58 per cent lost weight and 54 per cent reported an improvement in their skin. These figures are based on online questionnaires, not measured data. According to the Federal Centre for Health Education, high blood pressure can fall after four weeks; the liver, in particular, recovers.

Incidentally, you’ll be cutting out the calories from drinks: pure alcohol provides 7 kcal per gram, almost as much as fat, which provides 9 kcal. A 0.3-litre glass of beer contains around 130 kcal, whilst a 0.2-litre glass of red wine contains around 140 kcal. You can find out exactly how to plan your month in the Dry January guide.

After 3 months: blood test and lifestyle habits

Some changes take longer. The MCV, or mean corpuscular volume, is elevated particularly following prolonged alcohol consumption and, according to the guidelines, only returns to normal slowly, over a period of two to four months.

It is also interesting to see what effect a break has on drinking habits. Participants in Dry January 2018 drank even less in August than before: on 3.3 days a week instead of 4.3, and 7.1 British units of alcohol per drinking day instead of 8.6. A study involving 857 adults found lower alcohol consumption six months after January – even amongst those who hadn’t quite managed to complete the month. And it was only amongst people who successfully completed Dry January that well-being and drinking habits improved; this was not the case for other adults who continued to drink.

After 1 year and beyond: What matters in the long term

When it comes to cancer risk, we’re talking about years, not weeks. The International Agency for Research on Cancer (IARC) concluded that the risk of oesophageal cancer and oral cancer is likely to decrease over time following the cessation of alcohol consumption. There is preliminary evidence for laryngeal cancer, breast cancer in women and colorectal cancer. Significant effects only became apparent after around 15 years or more and were generally more pronounced in people who had previously drunk heavily, for example more than three drinks a day. According to the Cancer Information Service, the benefits of giving up alcohol completely are still difficult to assess for people who have only drunk in moderation, as most studies have focused on people with alcohol dependence.

Not everything can be reversed. Anyone who continues to drink risks developing fibrosis and, in the worst-case scenario, cirrhosis of the liver, which is incurable. Fatty liver, on the other hand, can be reversed at most stages if the underlying cause is addressed.

And what about the ‘before and after’ photos online? How quickly results become apparent varies from person to person. It depends on how much and how regularly you used to drink, and whether you have any pre-existing medical conditions. We didn’t find any reliable studies on appearance during our research; in the Sussex survey, just over half of the participants reported an improvement in their skin.

If you’re finding it difficult: help is available here

According to the Federal Centre for Health Education, anyone who resolves firmly not to drink but fails to do so should seek professional help. Addiction counselling centres provide information on alcohol and addiction and also offer advice to friends and family members. The BIÖG helpline is available on 0221 892031 from 10 am to 10 pm Monday to Thursday and from 10 am to 6 pm Friday to Sunday; calls can be made anonymously.

According to the guidelines, abstinence is the primary treatment goal in cases of alcohol dependence.

What you can drink instead

“Know your limit” advises holding your own glass of a non-alcoholic drink in your hand right from the start. Ideas from our mocktail menu – the quantities are serving suggestions, not strict recipes:

• Virgin Paloma: Pink Grapefruit, salt rim, a wedge of lime, 2 dashes of non-alcoholic bitters, plenty of ice
• Bitter Zero: Citrus, 4 cl non-alcoholic bitter aperitif, a slice of orange, filled to the brim with ice
• Green Zero: Lime & Mint, three slices of cucumber, basil, crushed ice, a pinch of salt
• Reaper Frizz: Sparkling, 3 cl freshly squeezed lemon and grapefruit mix, rosemary, frozen wine glass

According to the list of ingredients, our products do not contain any alcohol. The ‘Energy – Blackcurrant & Pomegranate’ flavour contains caffeine and is not recommended for children, pregnant women or breastfeeding mothers. Please note regarding beer: it may be sold as ‘non-alcoholic’ even if it contains up to 0.5 % vol.

You can find more recipes in the mocktails section; all varieties are listed under ‘Non-alcoholic drinks’. If you’re planning a break this autumn, read Sober October; if you want to drink more mindfully in general, read Sober Curious.

Frequently Asked Questions

Sources

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18. Food Transparency (Federal Association of Consumer Organisations): Why can beer containing alcohol be labelled as ‘non-alcoholic’? As at 26 March 26. lebensmittelklarheit.de
19. ACQUA REAPER: Product labels, 07–08/26.
20. Acqua Reaper: Product label for Energy Blackcurrant, as at 07/26.